“Everyone Should Have This Option”: Jan Rowe on Her Family’s Commitment to Death with Dignity

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To commemorate the 20th anniversary of the implementation of the Oregon Death with Dignity Act, we are featuring stories of those who in 1997 campaigned against the repeal of the law adopted by Oregon voters 3 years before and who continue to advocate for assisted dying laws nationwide. Today we are featuring Jan Rowe, a Death with Dignity advocate in Medford, Oregon. In 2014, Jan’s husband, Dr. Jack Rowe, used the Oregon law to end his battle with cancer. Jan and her daughter and Death with Dignity National Center Board member, Lisa Vigil Schattinger, advocate for assisted dying laws nationwide.

As Jan Rowe describes her late husband, Jack, during our phone interview in early September, I can’t see her face, but the warmth in her voice tells me she’s smiling.

“He was a wonderful man,” Jan says of Jack, who passed away in November 2014. “Very quiet, but very funny. He was incredibly intelligent: he read voraciously, he loved to build everything from puzzles to sterling engines, he was a woodworker, and he loved fly fishing,” through which he and Jan made good friends as they traveled in Oregon’s Rogue Valley and throughout the West.

Jan and the late Dr. Jack Rowe at Bryce Canyon National Park, Utah

Openness About Death

A neurologist who had practiced medicine in California and Texas, Jack was keenly aware of the Oregon Death with Dignity Act. Jan says he always was very supportive of the law. Throughout their marriage, Jack and Jan had talked openly about death and their belief in personal choice at the end of life.

“He believed in the right of a person with terminal illness to end life when he chose,” Jan says. He made it clear that he would make use of the law to hasten his death should he be diagnosed with a terminal illness. Jan and Jack both hoped that day would never come. But in September 2014, Jack was diagnosed with Myelodysplastic Syndrome, a bone marrow disorder that, in his case, would kill him within six months.

“He said, ‘I feel so incredibly lucky,’” Jan says. “Now I can take advantage of Oregon’s Death with Dignity law. It is my right to make this decision.’ He was ready to set a date because he was anxious about what his decline would present to him. He didn’t want to be physically incapacitated. He was already exhausted all the time.”

Experience with Death

Jan was no stranger to death. Her older sister, Connie, was first diagnosed with breast cancer in 1988. Following a mastectomy, she hoped her cancer was gone but she had a second primary breast cancer in 1994. Chemotherapy proved ineffective; she died in October 1995 after a prolonged and stoic struggle.

Despite her heartbreak, Jan says she has fond memories of lying in bed with her sister, “talking and being close,” as Connie spent her final days at a family home in Hawaii.

“It was an amazing experience,” Jan recalls.

Hospice Work

Inspired to provide comfort to other terminally ill individuals, Jan became a hospice care volunteer.

She gained significant exposure to death and dying–“I feel like I got a real education,” she says–and she enjoyed working with patients and their loved ones to help them prepare for the end of life.

She sat at her own father’s bedside for 3 weeks in 2012 as he died of age-related illness.

Jack’s Impending Death

As she grappled with the weight of Jack’s diagnosis, Jan found it difficult to come to a place of acceptance about his impending death and his decision to hasten his death.

“I was comfortable with his decision, but not with the timing,” Jan says. “Even though we had known that he was going to die before me, you’re still never ready when someone is actually dying. I was the one who said, I’m not ready, this is surreal. It took more than a month for me to finally agree that he needed to set a date in order to ensure that he would be capable of taking the medication by himself.”

Jack and Jan planned a celebration of life for Jack’s birthday in October 2014, to be held at the Medford, Oregon retirement community where they lived. Jan says they had to work around his scheduled palliative blood transfusions, which gave him some relief from being so exhausted and weak. Since he lacked the strength to stand up and give a speech at his party, Jack recorded a video welcoming his guests and “roasting” them with funny stories. Guests returned the favor, adding levity to the bittersweet event.

Jack and Jan Rowe (first row, center) with their family at a celebration of Jack’s life in October, 2014.

“It was so meaningful for him to be able to have that celebration, and to make a video for the friends who couldn’t come,” Jan says. “We also planned time for each guest or couple to spend an hour or two with him. That was the hardest part for him: saying goodbye to people who had tears in their eyes knowing they would never see him again.”

[Jack] said, “I feel so incredibly lucky. Now I can take advantage of Oregon’s Death with Dignity law. It is my right to make this decision.

Jan remembers the morning of the day before Jack chose to die.

“After we had breakfast, Jack said, ‘I want a hot dog for lunch.'” Jan says, laughing, that she told him she wouldn’t take him to Costco for his last meal! Their son James took him to a gourmet hot dog eatery in Medford instead.

That night, James helped Jack prepare the medication, which he would ingest with peach juice to mask the bitter taste.

The Day

The next morning, Jack took two medications to help ensure that he could keep the mixture down. Then he, Jan, and three of their children sat around the kitchen table for an hour; they told Jack they respected his decision and admired his courage. With that, Jack said, “it’s time,” and he began to prepare for his death.

He walked into the bedroom as Jan turned on his favorite music–a classical guitar compilation–and he got into bed.

“The rest of us followed him and sat down next to him. We said our last goodbyes; Jack took a couple of swallows of the peach juice mixture, said it still tasted “yucky” and then he finished it. “He started falling asleep within 5 minutes,” Jan says. “He slept deeply. His breathing slowed. It was obvious that he was not in any discomfort. He died within 20 minutes of when he first went to sleep.”

“It was just so peaceful and so exactly the way he hoped to die.”

After Death, Advocacy

After his death, Jan and the children sat around Jack’s bed and talked. It was a conversation with her daughter, Ohioan Lisa Vigil Schattinger, who later became a Death with Dignity National Center Board member, that sparked Jan’s commitment to become an outspoken advocate for Death with Dignity.

“Lisa said to me, Jack’s death was so peaceful and exactly as he had planned. We need to tell people about his experience,” Jan remembers. “She, at this moment, resolved to do something. That was the beginning of our involvement” with the Death with Dignity movement.

In January 2015, Jan and Lisa received an invitation from a friend to talk with a group of Bioethics Fellows at the Cleveland Clinic.

“By that time I felt very strongly that people needed to know about this option and how comforting it was for Jack and for our family,” Jan says. She travels twice a year to Ohio to help Lisa educate residents about assisted dying and the peace and comfort that a law like Oregon’s could bring to terminally ill Ohioans.

Volunteering with End of Life Choices Oregon

Jan, as a volunteer with End of Life Choices Oregon, has become a go-to source of information and advice about the Oregon law for the residents of her large retirement community.

“I’ve never wanted to do any kind of public speaking,” she says. “But people tell me that they are so grateful to know about how Jack died and to learn that this option is available to them, if they meet the rigid criteria. For me, it’s very important that people understand how the process works.”

A friend of Jan’s recently died of ALS. Jan says being able to explain to him how the law worked and to tell his family what to expect during the process gave all of them great relief.

“It was a gift to me to be able to give that gift to them,” Jan says.

“Beliefs”

Jack’s advocacy for assisted-dying laws continued even after his death. The Journal of the American Medical Association (JAMA) in September 2015 published his essay, entitled “Beliefs,” in which he described his professional struggle to reconcile modern medicine’s interpretation of “first do no harm” with his own belief that, sometimes, helping a patient to hasten her death is far less harmful than administering treatments that may prolong life in a painful way. He also explained his reasons for choosing to use the Oregon law.

“When JAMA contacted me, they wanted to include my email address,” Jan says. “At first I said no, but then I thought, I really want to know what sort of response this is going to create. I got over 50 emails from around the country. Of those, only one was negative.”

Sharing Jack’s Story

Jan works hard to dispel the “slippery slope” argument put forth by opponents of Death with Dignity: that assisted-dying laws can lead to patient abuse and even murder, in the form of involuntary euthanasia.

“The law has not been misused, it is not affecting the poor and the weak and the uninsured,” Jan says. Indeed, the reports from the Oregon Health Authority provide tangible proof that the law works as intended and has not led to abuse.

Jan also works with advocates in her home state and in Ohio to start meaningful discussions with the medical community. She notes that relatively few physicians in Oregon have written prescriptions under the law–according to the Oregon Health Authority’s 2016 report, only 102 out of the state’s more than 11,000 doctors wrote prescriptions last year.

“It’s still harder than it should be to access the law,” Jan says. “I wish we could inform more doctors about supporting Death with Dignity.”

For now, Jan will continue to connect with potential supporters by sharing Jack’s story.

“Telling our personal story is the most effective” way to help people understand that Death with Dignity is a humane and just option for the terminally ill, Jan says.

Her advocacy is a fitting tribute to Jack’s legacy.

“Jack had it written in his obituary that he died using the Death with Dignity law,” Jan says. “He wanted it known that that was his choice.” It was a choice he thought all Americans should have.

“Having his prescription gave him the control that he wanted at the end of his life,” Jan says. “Everyone should have this option.”